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Monday, March 26, 2018

Antibiotic Abuse

“Our modern medical system is built on effective antibiotics,” Eili Klein, an author on the study at the Center for Disease Dynamics, Economics and Policy in Washington DC. explained. “If our antibiotics stop working, if bacteria become resistant to most of them, medicine will be in trouble. The worry is that people don’t do anything about it.”The unrestrained use of antibiotics is the main driver for the rise in drug-resistant infections which now kill more than half a million people a year worldwide, including 50,000 in Europe and the US combined. Left unchecked, the spread of drug resistance could claim millions of lives a year by 2050. The danger posed by drug-resistant infections is so serious that England’s chief medical officer, Dame Sally Davies, has added antimicrobial resistance to the UK’s national risk register of civil emergencies. Despite efforts to encourage more prudent use of antibiotics, an international team of researchers found a 65% rise in worldwide consumption of the drugs from 2000 to 2015. The sharp upturn, revealed in sales figures from 76 countries, was driven almost entirely by rising use in poorer nations.Last month, Public Health England reported that at least a fifth of antibiotics prescribed by GPs in England for coughs and sore throats were unnecessary. A panel of experts convened by PHE found that while only 13% of people with a sore throat should get antibiotics, 59% did when they visited their GP.

Klein and his co-authors criticise the global response to the public health crisis as “slow and inadequate”. They call for a “radical rethinking” of policies to reduce antibiotic consumption, and advocate major investments to boost hygiene, sanitation, and vaccinations in countries where antibiotic use is rocketing. Without fresh interventions to curb overuse, the number of antibiotics handed out globally could rise more than 200% by 2030, from 42bn doses per day in 2015 to 128 billion, the researchers predict.

“In high income countries, the most important thing that reduced mortality from infectious disease in the 20th century was infrastructure,” Klein said. “Separating waste from drinking water and chlorinating it was one of the most important things we did.”

Beyond clean water supplies, Klein said vaccination programmes could also help to curb excessive antibiotic use, and so drug-resistant infections. While antibiotics are not effective against viruses, vaccines that protect against the flu and viruses that cause diarrhoeal disease would reduce the number of people being handed antibiotics unnecessarily. “The reality is that a lot of antibiotic overuse is for viral infections,” Klein said.